CD8+ Lymphomatoid Papulosis

Commentary about papular mycosis fungoides, lymphomatoid papulosis and lymphomatoid pityriasis lichenoides: more similarities than differences

“…The CD30+ cells in Kempf's report were described as small and occasionally medium‐sized and only mildly pleomorphic (lymphocytes with convoluted nuclei were not described). In our opinion, these examples of CD30+ PLEVA may be difficult to differentiate from CD8+ LyP‐B and LyP‐D where epidermotropic cells may obscure interface epidermal injury …”

Type D Lymphomatoid Papulosis: An uncommon Variant. A case report and review of the literature

“…Spontaneous regression of LyP is seen almost universally and recurrence in crops establish a chronicity that generally last for years, even though most of patients with LyP remain in good health. No clinical or pathological features can predict increased risk for developing malignancy and although it is not an aggressive malignant process, patients with LyP have an increased risk for developing a nonlymphoid tumour or more commonly a lymphoma (10-20%) including mycosis fungoides, Hodgkin's disease, and cutaneous and systemic CD30+ large-cell lymphoma and 10% of these are associated with extracutaneous involvement [3,9,21,22,[27][28][29][30]. The prognosis of LyP is characterized by disease-specific 5-year survival rates around 100%.…”

“…Cytotoxic molecules that do not imply a different clinical behavior as Granzime B and Perforin may also be found. In the case of type D LyP, the hallmark feature is the presence of small T-cells with epidermothropism that express CD4+ in addition to the CD30+ neoplastic cells [3,11,26]. Differential diagnosis.…”

“…Unlike LyP, the infiltrate tends to be more superficial and not wedge shaped, and tumor cells tend to be almost exclusively confined to the epidermis. Interestingly, CD30 positivity has also been increasingly reported in PR, and so confident distinction from this variant of LyP based on the immunophenotype alone is not reliable and ultimately depends on clinicopathologic correlation [1][2][3][4]. Clinical Course and Prognosis.…”

“…Nevertheless, LyP is recognized as a neoplastic process lying at the benign end of the spectrum of CD30+ lymphoproliferative diseases [1]. Clinically it is defined as a rhythmic paradoxical chronic, recurrent, self-healing eruption of erythematous papules and small nodules, characterized by a waxing and waning course and by histopathologic features of cutaneous T-cell lymphoma [2,3]. Four histologic subtypes of LyP are well recognized: (1) type A, characterized by a mixed infiltrate containing large atypical CD30+ cells admixed with small lymphocytes, histiocytes, neutrophils, and/or eosinophils; (2) type B, with a mycosis fungoides (MF)-like histologic picture; (3) type C, characterized by a more monotonous population of large CD30+ cells, similar to those seen in anaplastic large T-cell lymphoma and (4) type D, the most recently described variant, simulating an aggressive epidermotropic CD8-positive T-cell lymphoma.…”